ABSTRACT
Objective: Given the reductions in in-person visits and the increases in teleneurology visits, we sought to determine whether patients increased their use of virtual complementary and integrative therapies. Background: Patients with neurological disorders may seek treatment options in addition to those recommended by their providers. Prior to the COVID-19 pandemic, about half of patients from populations that sought care in neurology tried complementary and integrative therapies (CITs). Design/Methods: By examining two separate datasets that included cohorts of patients with neurological disorders, we assessed patients' use of virtual (and non-virtual) CITs and determined whether there were clinical characteristics that predicted their use. The two studies that comprised this report included one that examined patient and provider experiences with teleneurology visits, and another that assessed patients with a history of COVID-19 infection who presented for neurologic evaluation. Results: Patients who postponed medical treatment for non-COVID-19-related problems during the pandemic were more likely to seek CITs. Virtual exercise, virtual psychotherapy and relaxation/meditation smartphone applications were the most frequent types of virtual CITs chosen by patients. In both studies, age was a key demographic factor associated with mobile/virtual CIT usage. Conclusions: Data from our investigations demonstrated that, in addition to its other roles in teleneurology, CIT-related technologies may be utilized in the treatment of neurologic conditions.
ABSTRACT
Objective: To analyze the characteristics of commercially available sleep-exclusive apps using the Mobile Health Index and Navigation (MIND) apps database published by the Division of Digital Psychiatry at BIDMC for app review. Background: Over 70 million Americans endure a chronic sleep disorder during their lifetime. Due to the COVID-19 pandemic, mobile app benefits have been postulated as a means of expanding patient access to scientifically-based interventions in aiding their sleep disorders. With the increasing adoption of mobile health apps, it is critical that information regarding these mobile apps are sufficiently analyzed. Design/Methods: Using pre-specified criteria, we identified 106 sleep related mobile apps in the iOS and Google Playstores, and rated them using a 105 question review that is part of the MIND database. Questions focused on: Accessibility, Privacy & Security, Clinical Foundation, Engagement Style, and Interoperability. The features of the 106 apps were compared to a control group of non-sleep apps to evaluate the features and limitations sleep apps bear relative to the remainder of the marketplace. Results: The most common features of sleep apps were mindfulness (68.9%), deep breathing (54.7%), and psychoeducation (30.2%). Regarding functionality, 39.6% of apps have accessibility features and 49.1% can be used offline. However, sleep apps lack sleep trackers (22.6%), exportability features (21.7%), and opportunities to collaborate with one's provider (7.6%). Only 10.4% of sleep apps have an efficacy study. Conclusions: Sleep apps in the marketplace are primarily used to help the user fall and stay asleep. In its current state, sleep apps can assist only the user as a self-help tool. The lack of sleep tracking, support, exportability, the inability to collaborate with one's provider and efficacy studies limit the potential of implementing sleep apps for clinical use.
ABSTRACT
Objective: We aimed to assess the characteristics of the pain application (app) marketplace and determine improvements to mobile health (m Health) that could assist patients with pain disorders in obtaining more accessible care. Background: During the COVID-19 pandemic, complementary and integrative therapies delivered via mHealth technologies have become more popular due to their accessibility. As more users are downloading apps to address health concerns, it is important to analyze the ever growing marketplace's features and limitations. Design/Methods: After searching the iOS and Google Play Stores for commercially available pain apps that met pre-specified search criteria, trained app raters entered 47 apps into the Mobile-Health Index and Navigation Database (MIND) published by the Division of Digital Psychiatry at BIDMC. Through a 105-question objective rating framework, each app was evaluated for its accessibility, privacy, cost, functionalities, features, and clinical foundations. The data was compared with a control group of non-pain apps-matched for platform and cost -to examine the traits of pain apps in contrast with the rest of the marketplace. Results: The top features were 44.7% (21/47) offered symptom tracking, 34.0% (16/47) offered medication tracking, and 42.6% (20/47) offered physical health exercises. Just 2.13% (1/47) of apps offered HIPAA privacy protections or had a crisis management feature. Additionally, only 10.64% (5/47) of pain apps were supported by efficacy studies. Conclusions: Commercially available pain apps are typically used to record pain episodes or document medications. However, the lack of privacy, crisis management, and efficacy studies may be preventing their clinical implementation.